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目的:探讨腹膜后纤维化致上尿路梗阻的临床特点及诊治方法。方法:回顾性分析暨南大学医学院第五附属医院从1995年2月至2008年5月收治的11例腹膜后纤维化并肾积水患者的临床资料。结果:术后随访12～36个月,9例术后肾脏功能有明显改善,6例静脉肾盂造影提示术后肾脏积水明显好转。特发性腹膜后纤维化病例纤维化程度未见明显加重,病情稳定或无变化。结论:影像学检查是发现和诊断腹膜后纤维化的重要手段,输尿管松解加大网膜包裹或腹腔移位术、输尿管镜腔内手术等联合药物治疗是主要的有效的治疗手段。
Objective: To investigate the clinical characteristics and diagnosis and treatment of upper urinary tract obstruction caused by retroperitoneal fibrosis. Methods: The clinical data of 11 patients with retroperitoneal fibrosis and hydronephrosis admitted to the Fifth Affiliated Hospital of Jinan University from February 1995 to May 2008 were retrospectively analyzed. Results: All patients were followed up for 12-36 months. Nine cases had significant improvement of renal function and 6 cases of intravenous pyelography showed that the postoperative hydronephrosis was significantly improved. Idiopathic retroperitoneal fibrosis no significant increase in the degree of fibrosis, stable condition or no change. Conclusions: Imaging examination is an important means to find and diagnose retroperitoneal fibrosis. Ureteral lysis combined with omentum wrapping or peritoneal transposition and ureteroscopic surgery is the main effective treatment.